Part 40

Diagnosis. It is especially important to distinguish this from =hæmoglobinæmia=, which shows an uniform red or brown discoloration of the urine and an entire absence of blood globules as such. In congestion the reddish material tends to precipitate and is found to consist largely of blood globules. It is further associated with albuminuria.

=Hæmorrhagic cystitis= and =cystic calculi= are both chronic affections, and identified on rectal exploration by the tenderness of the bladder and the presence of the stone.

Prevention consists in the avoidance of the various causative factors, and especially those that find access among alimentary matters. Cattle turned out in early spring should be fed before going and should be returned from the pasture in an hour or two. This repeated day by day, allows the digestive and urinary organs to accommodate themselves to the fresh spring grass and to any vegetation to which the animals have not been accustomed. Chills, draughts, injuries and other disturbing conditions must be guarded against.

Treatment. Bleeding is strongly recommended by Cruzel and Cadeac. In Germany, England and America derivation toward the digestive organs is more generally relied on. Laxatives should be, as in the horse, oleaginous (castor, olive, linseed) or manna, rather than agents that may perchance act on the kidneys. Free purgation should be secured. Flaxseed tea, and wet compresses over the loins are valuable adjuncts, and anodyne agents like camphor, bromide of camphor, or other bromides may be added, and when there is any suspicion of infection, salicylates, or iodide of potassium may be employed. Finally a course of bitters (salicin, quinine, nux,) may be employed to restore tone and iron carbonate with sodium carbonate as a reconstructive tonic. The diet must be changed to wholesome food, but not too stimulating, and the animal kept quiet.

ACUTE CONGESTION OF THE KIDNEYS IN SHEEP AND GOAT.

Causes: irritant food. Lesions: Symptoms: separates from its fellows, arched back, stiff straddling gait, straining, muscular weakness, recumbency, urine red, with blood globules and albumen. Prevention: care in feeding and watering, change of pasture and treatment as in the ox.

Causes. As in cattle, the smaller ruminants appear to suffer especially from an alimentary renal congestion, showing itself mainly in animals that are unaccustomed to the particular toxic aliment. Thus, Cornevin finds that the Pyrennean sheep thrives on the leaves of the Quercus tosa, while Southdown sheep taking it in any considerable quantity perish of renal congestion or nephritis. Similarly Weith fed four sheep on cynanchum vincetoxicum and developed renal congestion in the course of three days. Other causes doubtless contribute in individual cases but have not been specially traced to their effects.

Lesions are in the main the same as in cattle, the kidneys being bluish red, soft, flaccid and friable.

Symptoms. The sheep lags behind the flock, frequently lies down and rises, strains to urinate, and passes often considerable quantities. The back is arched, the loins tender, the walk stiff and straddling, the pulse small and weak. If the disease advances, there come on extreme muscular weakness, a disposition to lie, an uncertain, gait, with frequent stumbling, dullness, stupor, and it may be coma. The urine is usually tinged with blood or of a deep red or black, and contains well-formed blood globules and more or less albumen.

Prevention and treatment should proceed on the same lines as in the ox, but in dealing with a large herd it becomes difficult to treat each separate case with special care. The avoidance of sudden change of food as in turning out in spring, the feeding of grain before turning out, the return to the fold after a short freedom, and the gradual transition to the new food are important. When the disease has developed, an entire change of pasture or food, the use of roots, ensilage, or grain, or of freshly cut meadow grass, is indicated, and an oleaginous laxative (castor oil 2 to 3 ozs.) are indicated. Oilcake or flaxseed meal will often prove a most valuable article. Beyond this the same agents would be indicated as for the ox.

ACUTE CONGESTION OF THE KIDNEYS IN SWINE.

Causes: infection, toxins, fermented food, traumas, crowding, cold. Symptoms: stiff loins and quarters, frequent micturition, urine limpid or red. Treatment.

Renal congestion in pigs has been seen mainly as the result of toxin poisoning in swine erysipelas, hog cholera or caseous pneumonia. It is also liable to occur from putrid or overfermented food, and in fat, heavy animals from injuries sustained in shipping by rail by trampling on or squeezing each other. Kicks and other injuries may at times contribute to its occurrence. Exposure to cold storms, to which swine are especially sensitive, a wet, cold bed, or a leaky roof, are additional causes.

The symptoms are more or less stiffness of the loins and hind parts, frequent urination, the secretion being often passed in excess, and though at times clear yet at others pink or bloody and precipitating blood clots or at least containing blood globules.

Treatment is mainly prophylactic. If therapeutic measures are desirable for valuable animals, they should follow the same lines as for sheep: rest, fomentations, aqueous food, anodynes, weak alkaline diuretics, laxatives, and balsams.

CONGESTION OF THE KIDNEYS IN CARNIVORA.

Causes: acrid diuretics, loss of kidney, catheterization, dermatitis, burns, traumas, overexertion. Lesions: enlarged, blood-gorged kidney, red or black, petechiated. Symptoms: stiff, arched, tender loins, tardy, dragging of hind limbs, urine passed often, clear to bloody, albuminous, anorexia, nausea, vomiting, diarrhœa, dullness, stupor. Treatment: stop cause, give emetic, laxative, in surgical cases antiseptic, for cantharides, camphor, bromides, vegetable food. Warm clothing or building.

Causes. This comes most commonly from the ingestion of acrid or diuretic agents, saltpeter, turpentine oil, cantharides and, according to Cadeac, various essential oils including oil of mustard. It takes place in the remaining kidney after the one has been extirpated, or had its functions abolished by disease or urethral obstruction. Again, surgical operations on the urinary organs, even the simple passing of a catheter, will cause sympathetic renal congestion. Extensive acute dermatitis, and burns of the skin may have a similar sequence.

Falls, kicks, blows, or crushing beneath a wheel or otherwise are additional causes.

Finally violent overexertion as in coursing, causes congestion with albuminuria, and blood globules and even casts in the urine. This is common to the human athlete, who undergoes a violent and continued overexertion, race and draught horses, and dogs.

Lesions. When congestion is produced experimentally by cantharides the kidneys are found to be enlarged and the cortex gorged with blood so that it has a deep red or blackish port wine hue, with here and there spots of ecchymosis. The veins, capillaries and glomeruli are especially congested, and the epithelial cells of the convoluted tubes have become laterally distended, so that they approximate to a globular form. A loose coagulum containing blood globules may be found in the capsule of the glomerulus and in the convoluted tubes.

Symptoms. These are arching and stiffness of the loins, a tardy, dragging movement of the hind limbs and tenderness of the loins. The urine may be scanty or in excess, and tends to be passed frequently, in small quantities and with evidence of pain. It may be clear, pinkish or bloody, and shows albumen and frequently casts, and blood globules or small clots. There is some impairment of appetite, and, in severe cases, nausea and vomiting, with, it may be, diarrhœa, nervous depression, dullness and stupor. When due to poison or other transient cause the symptoms improve when this factor has been stopped.

Treatment. When due to poison taken by the stomach this must be stopped, and the stomach and bowels evacuated by an emetic (ipecacuan) and laxative (sodium sulphate). Appropriate treatment must be made in case of burns or skin eruptions. When surgical cases are due to infection rather than simple shock or sympathetic irritation, antiseptic injections of the bladder are indicated. In all cases alike a warm bath is an important adjunct. When irritation is due to cantharides, it may be calmed by camphor, 2 grains every three or four hours. Other anodynes may be given as required. Rest is essential and, as appetite is recovered, a moderate amount of amylaceous puddings. A warm building or comfortable clothing is desirable.

NEPHRITIS.

The renal inflammations have not been fully investigated in the domestic animals, and even in man, the pathology of several of the forms is still enveloped in some measure of doubt. In man the following conditions have been noted:

1st. Acute parenchymatous nephritis with enlarged kidney and degenerated tubules.

2d. Chronic parenchymatous nephritis with enlarged kidney and degenerated tubules.

3d. Acute diffuse (desquamative, interstitial) nephritis with enlarged kidney and glomeruli, tubules and connective tissue degenerated.